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Pad, ~~rl-~ R~~u~tlon Act N~ Yee
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hot,rs as an
<br />avcrege per response for some minor facilities, to 110 hours as an average per response s"or same major
<br />facilities, with a weighted average for major and minor facilities of 18 hours per response; including time for
<br />reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
<br />completing and reviewing ttte collection of information, including suggestion for reducing this burden, to
<br />Chief, Information Policy Stanch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.VJ.
<br />4tlashington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Budget, \Nashington, DC 20503.
<br />heneral Instructions
<br />1. If form has been partially completed by preprinting, disregard instruction directed at entry of that information already
<br />preprinted.
<br />2. Fnter "Perm%rh:e Name/Mailing Addrass (and facility name/locar'on, if different)," "Permit NumFer;' and "Dis.;ha Ee
<br />Numh~r" where indicated. (A separate form is required for each dischazgeJ
<br />3. 5ntcr Batas heginning and editing "1vLnitoring P~ rioJ" covered by form where indicated.
<br />4. L-ntcr each "Par-arr~t'r" as specified in monitoring requirements of permit.
<br />5. °n!.'r "SrnrFlt iv1_ ~se~:rm:at"data far each parameter wrdcr ";.rnmih,."led ;,luaiifj~"as specified in permi?. '~la•, ~~s" is
<br />torn&tly arithmetic rvcrage (geornctric avenge for bcctcrisl pa.zunc'srs) of all sample mcaswcrocc!s for each pa a nc:,:r
<br />obta~ncu Burin;; ",~r-, • %zri;r~ f~ri~1"; ",1ir.i„ran" , nd i'rli,r4n:nn" aru rnrmally c,l~:urc high and low mcasurc-~ents
<br />nbtaired during "n;~:+4~.,~i,r6 P~,-i-1". (~'otc to ~~~uric gels c;F'~. secondary treatment ~ .:irement: LaLr 30-day avc~a~c
<br />of sar~r'e rne~sucemr :~ under "v/°: r.; _, a~rd en:e~ ,r+~imum 7-da, average ofsa:r,-,lc mcasurcmCnfs obtcincd uurirg
<br />mon;.a~ing period under '9v~asinru..r.") ,
<br />u. ?n'?r"Fr,:ail.R:;ar;.eu~snr" or each parameter under"~,:];dih.~"air:"~:+tr/try"assptcif:rdinpc*rni[.
<br />7. Ur.d.r ";.'-, F_ " rntrr ~,~umu:, of sample mca~n~eme~-[ :]urin7t c:u .~'~~ ing ;,. r;nC !I-c' z~.c.ed ma:.imun (and/or rai.~;mum
<br />nr 7 d.; aver,;,: as rl,p:opri:.tc) p_riit rcvu'!emcn[ f:n carte pamm;;te~. ;fn~ne, ea'cr "^".
<br />P. Pmrr "Fr~;a.,r_~+ .f 0;v/~,,r; e" be:n LLs "5~,. ,-'_ d4 v~ ~+, o,,.•at" (ncfu, t fre: uerey n' sa „-,Ling end enulysis used dvrng
<br />~~unP,a~~ ig Period) e.n~ as "P_r..,ir r~:~ui,-~r,. ur"s;-reei~~d in pucui!. (c.g. Lrt~r " „ic„ cont.~uous moni,oia„ "r/7"
<br />fcr rape d.~y per wee':, "i/30" fog ace dxy fen month, "//90"for unc day per eucrtcr, e. c.)
<br />9. flY_r ",S~rr, L• T,'; "butte s ".v~r~r~l' i,; _~v ,~e,. tn!" (ech:al sninp;c type used du~~~ rnaaitn~in„ per'nd) arc as' P-•~-„~~'.
<br />•',~.iri~:°,n":r," (e.j;. Lnte; "v+~t~" for indi.id_~ol ..,nple, '?~'N:" Fcr Z~+ho~:~ co,nposne, '~%r" `or conlinuar+s
<br />monitoring, etc.)
<br />10. \'^..rc violations cf permit reovirements arc 'epo-[ed, attadt a brie.` =splenatinn to e~_;crihe cau.,e and ecrr~c'.ive ac:ioas
<br />to be ta!:cn, and reference each violation by date.
<br />~ 1. if"nc drsrhar~e" occurs dung mcnltoring p:riud cnt ~ "iJu ^ischarge" across form in p!acc of data entry.
<br />t2. F.n~cr "N~ra_/TilL rjFri:reipc+! F.r.uuriir L~ sr" with "Si~n~lura rf /'rir_i~~l Fz:~-rrn: Gffi_er f Atrrir.rivl
<br />/,gent, ""Tali ph7rra A4:inter, "and "Dar. " at bottom of form.
<br />13. Dail signed Report to Oflicc(s) by date(s) specified in permit. Retain copy for your records.
<br />14. More detailed instructions for use of this Discivrbz lvfaritoring RzF~r-t (I?F.~ form may be obtained ~rom O~cc(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result in
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation,
<br />or by imprisonment for not more than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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